Background - Health care associated infection is the most common injury related to hospitalization in Sweden. This implies a major suffering for patients affected and requires unnecessary resources from health care. In every tenth hospital bed there is a patient who has been exposed to a health care associated infection. The primary source of transmission is through the professionals' hands. There is a great need to reduce the spread of pathogens that cause health care associated infections. Nurses represent a large part of the workforce in health care, where their thoughts about hand hygiene are of interest to find out why health care associated infections occur.

Aim - The aim of this study was to describe registered nurses' thoughts about hand hygiene. Method - In this literature based study nine qualitative articles were analysed by a method described by Friberg (2012).

Results – The three main categories were for whom my hands get washed, difficult to follow hygiene guidelines and want to be better. Nurses' motivation to follow hand hygiene practices is primarily based on protecting themselves against microorganisms. Nurses' have knowledge about the guidelines but choose to apply their own rules. Nurses follow the examples set by others, whether they have a good or bad behaviour. Conclusion - Nurses need more knowledge in why hand hygiene is important in order to change their mindset for whom hand hygiene is performed. Nurses have a need of role models who can motivate them and set a good example.